title: "To be a phenomenal doctor you have to be the whole package": physicians' interpersonal behaviors during difficult conversations in pediatrics.
abstract: BACKGROUND
  Delivery of bad news is a challenging task for physicians and other health care professionals. Several studies have assessed parental perceptions of the delivery of bad news, but none have focused on the role of physicians' interpersonal behaviors in the communication process.
  
  
  OBJECTIVE
  The study's objective was to assess parental perceptions of physicians' interpersonal behaviors and their role in communication of bad news.
  
  
  METHODS
  The design was a cross-sectional qualitative interview study of 13 parents of patients hospitalized or previously hospitalized in the pediatric intensive care unit or oncology/bone marrow transplant unit at an academic children's hospital.
  
  
  RESULTS
  Eleven interpersonal behaviors were identified as important by parents. The majority of parents identified empathy in physicians as critical. Availability, treating the child as an individual, and respecting the parent's knowledge of the child were mentioned by almost half of parents. Themes also considered important but by a smaller number of parents were allowing room for hope, the importance of body language, thoroughness, going beyond the call of duty, accountability, willingness to accept being questioned, and attention to the suffering of the child.
  
  
  CONCLUSIONS
  To increase parental satisfaction and enhance the parent-physician therapeutic partnership, we recommend that physicians consider attending to the 11 interpersonal behaviors described in this manuscript, and that educational programs pay particular attention to these behaviors when training health care providers in the communication of bad news.
authors.affiliation: Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. a_orioles@hotmail.com
authors.forename: Alberto
authors.initials: A
authors.lastname: Orioles
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Miller
authors.forename: Leslie S
authors.initials: LS
authors.lastname: Kersun
authors.forename: Mary
authors.initials: M
authors.lastname: Ingram
authors.forename: Wynne E
authors.initials: WE
authors.lastname: Morrison
mesh_terms: D003142:Communication; D003430:Cross-Sectional Studies; D004645:Empathy; D005260:Female; D065026:Hope; D006776:Hospitals, Pediatric; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000592:standards; D007407:Interviews as Topic; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education / Q000523:psychology / Q000592:standards; D016522:Oncology Service, Hospital / Q000592:standards; D010290:Parents / Q000523:psychology*; D010372:Pediatrics / Q000193:education / Q000379:methods / Q000592:standards*; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D036301:Qualitative Research; D014342:Truth Disclosure; D000078329:Workforce